Professor Graeme Clark

GEORGE NEGUS: Tonight, the Australian whose sheer tenacity has blessed tens of thousands of deaf people around the world with the unexpected ability to hear.

G'day, and welcome to another in our series of Thursday night profiles.

For quite a few years now, you and I, with pretty dubious scientific validity, it has to be said, have probably been referring to it as the 'bionic ear'. But to its creator, Professor Graeme Clark, it's the 'multiple-electrode cochlear implant'. This thing, an Australian invention hailed as one of the most significant breakthroughs ever in medical science. It's the first and, so far, only device that actually restores brain function prosthetically.

The implant is the first and, so far, only device that actually restores brain function prosthetically

Professor Clark's mother was very creative and encouraged him, as a child, to explore his interests

Professor Clark finds it a moving experience to be able to assist children to communicate with their parents

Margaret Clark says her husband is a very determined person

As a child, Graeme Clark apparently had an inventive streak that led to all sorts of antics in the family laundry in the name of scientific experimentation. Later, at uni, he topped medicine and became consumed by an almost overwhelming urge to make discoveries. And this eventually led to the implant idea. This little device. But that said, for years the Professor copped plenty of scepticism and even ridicule from his own profession, until a major breakthrough in 1978, when a Clark implant allowed Rod Saunders, who'd lost his hearing at 46, to hear again. 25 years later, more than 50,000 people worldwide have benefited from his life-enhancing little device. We'll chat to the man himself in a moment, but first, how his childhood and family life not only had a significant bearing on the career of this most remarkable inventor, it actually caused it.

PROFESSOR GRAEME CLARK, COCHLEAR IMPLANT INVENTOR: It was a special childhood. My father had a hearing problem. He hadn't a very good hearing aid, and people came into the country town of Camden, where the pharmacy was, and they'd ask for confidential items. Dad would ask them to please speak up. So everyone in the shop knew what they were after. So whenever they came in and I was there, I'd signal to him I heard  I knew what it was. I'd rush to the appropriate drawer and get the items.

I was in a country town. I had a mother who was very supportive. I had a nature that was very dynamic and wanted to explore all sorts of things. And the country environment allowed me to do that. I did work in my family laundry, doing all sorts of experiments at a young age. I look back now and I think, "Well, I really was setting out to do some analytic studies even then." And that never left me, that fire in the belly. And I wrongly thought I should be headed off into medicine, but the doors all opened up in surgery. I entered into partnership with a friend of my father's, learning to be an expert nose and plastic surgeon. Even in spite of the ability to mould noses like I do these pots, I found that the fire in the belly was not satisfied and I felt that I must satisfy my urge to be a research scientist.

I had been frustrated in my practice at seeing profoundly deaf people come and realising that I couldn't tell them we could do anything for them. But then I got this inspiration to go and do the work by electrically stimulating the hearing when I read this article by an American surgeon  Simmons. We left to go and live very poorly as a research student at the University of Sydney. And, uh, our second-hand car broke down. We couldn't afford another second-hand car, even. I could spend time thinking about my research at bus stops, walking here and there, instead of worrying about the frustrations of driving in the traffic. I can tell you that I never felt, I don't think, so happy in my life, as when money and financial success were unimportant.

HOME MOVIE FOOTAGE OF A YOUNG GRAEME BALANCING ON A DIVING BOARD:

GEORGE NEGUS: Graeme, good to see you.

PROFESSOR GRAEME CLARK: Thank you. Very nice.

GEORGE NEGUS: Did you... did you dive backwards into the lake?

PROFESSOR GRAEME CLARK: I nearly did, um...

GEORGE NEGUS: I thought you were going to.

PROFESSOR GRAEME CLARK: Yes, I just withdrew at the right time.

GEORGE NEGUS: That was very vivid family recollection for you, I imagine, because you say quite openly that you had a very good family background.

PROFESSOR GRAEME CLARK: I was so fortunate. Mum and Dad were wonderful parents, uh, wonderful family. And, you know, I had that sense of security, and... I think that really gave one a real good start in life.

GEORGE NEGUS: Is that what made you feel confident to do things that were a bit outlandish? I mean, you've always been an experimenter and a discoverer  someone who wanted to do things that hadn't been done by other people. Did the security your mum and dad gave you make that possible?

PROFESSOR GRAEME CLARK: Not only the security, it was the stimulus, um... Mum was a most creative lady, and I was a terribly active and demanding child. Mum spent a lot of time saying to me, "Now, Graeme, you can do this." And I kept saying, "I finished that, Mum. What can I do next?" And, uh, I did an awful lot. And Dad, on the other hand, he was the more solid member of the family. And Dad really encouraged me to mix up all these potions, read the doctors' prescriptions, get to know what was going on in medicine. Dad was a man who had integrity. He was very good at relating to people as he would have to do in a pharmacy. And I was so impressed, that even though... when people might come into the shop and ask for antibiotics  which was illegal to give over the counter  Dad wouldn't give it to them. And I learned you can stand up for what is right, even though you might lose out.

GEORGE NEGUS: You don't have to bend the rules.

PROFESSOR GRAEME CLARK: You don't.

GEORGE NEGUS: Eventually you did a lot of good for yourself by that, because you stuck to your guns too, didn't you?

PROFESSOR GRAEME CLARK: Indeed  there were many times, in any person's life, where you may want to get funds from this source, and it's not appropriate, and, uh... There were times when you do have to make these difficult decisions. Uh, I always thought of my dad. I have to stick up for what's right and do what's right.

GEORGE NEGUS: How did you know, at 10, that you wanted to get into the ENT game?

PROFESSOR GRAEME CLARK: Well, it started...

GEORGE NEGUS: Very young to know you wanted to muck around with noses and throats.

PROFESSOR GRAEME CLARK: Well, I had Dad as the person I wanted to try and help, because of his deafness. He was what we'd call severely deaf. He had a, uh... a poor hearing aid at that stage. He was severely deaf and not aided well enough to really have a difficulty. Not only in the shop, but even in our family life he was a problem.

GEORGE NEGUS: So it was your father's... the impediment that it caused in his life that sparked something in your brain and your soul, almost, to do something about it?

PROFESSOR GRAEME CLARK: Yes, indeed. It was both the fact that he had that handicap... I love... I came to love medicine in this country town, and then the eye side also came into it. I used to be allowed to look into the back of people's eyes when I was a young kid. So eyes and ears all came together, and, you know, I had a passion then to help people.

GEORGE NEGUS: Yep. So where did the original idea for the implant come from?

PROFESSOR GRAEME CLARK: Well, there's no one original idea. Uh, there's been so many different things to bring together to create a bionic ear. My first motivation came when I was rushing from one operating session to another in Melbourne and I stopped in the park to read the latest journal and saw this article by Blair Simmons, where he'd actually put wires into a person's nerve and stimulated them  got some sensations, but no real speech. And I knew then, for some reason, that that's my mission in life. So I left practice in Melbourne  a fairly lucrative practice  because I really wanted to set out to do it scientifically, systematically. Because I knew that if there was any chance of us being able to achieve a goal, I had to do it carefully, scientifically, and get a good basis...

GEORGE NEGUS: So you needed to go from practising, as such, to research, to get to your next stage.

PROFESSOR GRAEME CLARK: That's right. It was a shock to the system.

GEORGE NEGUS: And to you wife and family, I imagine. And you seriously believe that living in those very restricted fashion  you were pretty poor, you said  was actually a plus?

PROFESSOR GRAEME CLARK: There were no pressures to get a second house, to get a farm  which is all the pressures that you have to suffer when you become a successful, uh, surgeon.

GEORGE NEGUS: Yes. A middle-class professional and all that sort of stuff. I think, as a result of that piece, people will sell their cars or leave them and walk to work to get a brilliant idea like yours. But you managed to achieve your goal despite the fact that, as I said earlier on, a lot of criticism, a lot of ridicule, a lot of scepticism about what you were doing. Let's have a look at that and then talk.

ARCHIVAL FOOTAGE:

PROFESSOR GRAEME CLARK: One very important area that needs developing is the receiver and the transmitter that can actually apply these electrical stimuli to the patients.

PROFESSOR GRAEME CLARK: This whole development was criticised all along. Firstly from scientific colleagues, who said it wouldn't work. Then I was criticised by medical colleagues, because they thought that what I was going to do would be dangerous. Every day was difficult, and I chose a very peaceful place in Eltham to live, which made enormous difference. I made a point of actually growing up with the kids. I made my hobby, in the weekends, to play with them, to share with them. Instead of going to the golf course, I went to the backyard with the kids. I never stopped thinking, and the holidays  apart from playing with the children  my brain never stops. It was one of the joys of holidays  to actually think about work.

MARGARET CLARK: He is actually very determined. He just prayed about it and just kept going in his own, um... determined way. He is actually very determined.

SIR GUSTAV NOSSAL, PROFESSOR EMERITUS, UNIVERSITY OF MELBOURNE: The qualities which it took to develop the bionic ear can be very simply summarised. They are ingenuity, dedication and an unshakable belief in the validity of the dream.

PROFESSOR GRAEME CLARK: Everything I did, I felt I was breaking new ground. I couldn't work out how to get the electrode bundle to go round the tiny spiral, and it bothered me day in and day out, and I went away on holidays really struggling to find an answer. And then, amazingly, one day at the beach, eureka! I was playing around with a shell like the inner ear and putting in bits of grass blades, and realised that if they were bendable at the tip and stiff towards the base, they would actually go around far enough. I raced home from my holidays and tried it out in the laboratory, and it worked. I was able put the multi-electrodes around the tiny spiral of the inner ear. That bundle of electrodes is then connected to a package of electronics that lies underneath the skin that enables us to control the stimuli by sending radio waves through the skin to that implanted electronic package.

MAN ON NEWSREEL: The surgery was carried out with strict measures to prevent infection.

PROFESSOR GRAEME CLARK: I chose Rod Saunders as the first patient because he'd only recently gone deaf, and I assumed that he'd have good memory for sound.

LABORATORY ASSISTANT: Say these sentences after me. Eat the apple.

ROD SAUNDERS: Eat the apple.

PROFESSOR GRAEME CLARK: When he heard speech, I knew that all our hard work had been successful. It was one of the most wonderful experiences of my life. I was so overcome, I went into the next-door laboratory and did what's not very Australian  I burst into tears of joy.

GEORGE NEGUS: It's not quite un-Australian these days, is it? Probably in those days it was, wasn't it, for a man to cry because he was overjoyed?

GEORGE NEGUS: They do. That must've been a huge moment for you when that all worked out. Why did they say it wouldn't work? Why the level of scepticism that you received?

PROFESSOR GRAEME CLARK: Well, I find it hard to be quite sure, but I think one reason is that, uh, at the time, science had shown how sophisticated, how beautiful the inner ear was, and has 20,000 nerves supplying it. And here I was saying, "Oh, we reckon we might put 20 nerve  or wires  in the inner ear to stimulate it, and how could we be successful?" And the other reason is that I think scientists are very good at trying to work out why things won't work.

GEORGE NEGUS: Had you assessed how much danger you thought there was? Or did you think there was none?

PROFESSOR GRAEME CLARK: I knew that there was a risk of, uh, meningitis, uh...

GEORGE NEGUS: Why meningitis? Pardon my ignorance in these matters, but why might it cause meningitis?

PROFESSOR GRAEME CLARK: It might cause meningitis because the middle ear infection can actually spread to the inner ear, and then there are pathways going to the brain. And we had known that when we did stape surgery way back, uh, a little before this, that some people got meningitis that way. And so that was the reason the colleagues thought it was risky. But I had been very careful  as careful as I could  to do a series of experiments in animals to try to see...

GEORGE NEGUS: Which also upset some people.

PROFESSOR GRAEME CLARK: Yes, I got into trouble for that too.

GEORGE NEGUS: Must've really upset you, though, to hear the Deaf signing people get upset the way they did  or some of them. Did you expect that?

PROFESSOR GRAEME CLARK: Having shown that it worked in adults and having shown there was a reasonable chance to help children, the first thing I hear is... the signing Deaf community say they don't want to hear.

GEORGE NEGUS: They don't want to hear?

PROFESSOR GRAEME CLARK: They didn't even think that it was, uh... appropriate or right for people to hear, that deafness was a beautiful state. Well, I felt that we needed to give the right for all children to be able to mix in a world of sound, and to be able to have the opportunities to talk with you and me and others and develop their true potential. I have great respect for the signing community. I have great respect for what Abbe de L'Epee did at the French Deaf School 200 years ago. He did wonders with the sign language. But we've moved on.

GEORGE NEGUS: Have they come around? The signers?

PROFESSOR GRAEME CLARK: Many have come around. Most parents who have deaf children now want their children to hear. And, uh, the community has got smaller. Which is unfortunate, but that's the way it is. Uh, but it's still possible for someone who has an implant to also be able to sign later on. What I didn't want to see happen was the decision whether to have an implant or sign left till they were 18 or 19, when it's too late to have a bionic ear.

GEORGE NEGUS: 50,000 successful-faced customers, as it were, later  people must be pretty much convinced now that it works.

PROFESSOR GRAEME CLARK: Oh, indeed. And it wasn't till the teachers of the deaf actually said, "Look, we've never seen anything like this before." When they, with all their experience in educating deaf children, said, "It works, it's great, it's fantastic," then I knew that we'd been successful.

GEORGE NEGUS: Before we move on  we've gotten a lot of beaut little things here. What's the line-up here? This is what I showed the folks at home. That's the latest model, isn't it?

GEORGE NEGUS HOLDS UP A COCHLEAR SMALL DEVICE:

PROFESSOR GRAEME CLARK: That's one of the latest of Cochlear's models. But we went there  before that, this became the workhorse. This here is the, um... That there is one of the first devices made by Cochlear in conjunction with our team, to actually implant in children. It was a big step forward from our early device, which didn't have this nice, neat way of connecting up.

GEORGE NEGUS: And this is the voice processor here, isn't it, that's also part of the whole... process?

PROFESSOR GRAEME CLARK, HOLDING UP DEVICE: This is the speech processor, voice processor. It's a little computer, you might say, that sends the signal via this coil to transmit through to the skin, uh, to the implant. But... this is where we're at now.

GEORGE NEGUS: This is the designer model.

PROFESSOR GRAEME CLARK, HOLDING SMALL DEVICE: This... I never thought would get to that stage, really. And that now fits behind the ear, and, uh, one day, before too long, the speech processor, the implant...

GEORGE NEGUS: Everything implanted.

PROFESSOR GRAEME CLARK: Everything implanted.

GEORGE NEGUS: You just won't stop, will you? I think that's very interesting to hear that, expressed so simply too. I could almost understand it. You're obviously not the sort of person who just lives on your successes. You're up to things now, as I hear it. Let's see what you're up to now, after the implant.

PROFESSOR GRAEME CLARK: My greatest goal was to help children born deaf. We weren't sure whether they had the right brain mechanisms, having not heard, to be able to take advantage of the bionic ear. So that was a real, uh, challenge for me personally.

FOOTAGE OF WOMAN HOLDING INFANT:

DAVID MOSS: When they put the first few sounds through to him, he basically stopped and looked around to see what was going on.

NANCY MOSS: He was scared at the time, also. But he coped through it quite easily. He adjusted very well, very quickly. So it was nice. It was a really quite emotional time for us.

DAVID MOSS: From a child that we weren't sure we'd ever hear him talk, uh, we can talk to him, he can talk to us. He's going to live a pretty normal life, I would expect.

PROFESSOR GRAEME CLARK: Being able to communicate with their parents and live like normal children and in a hearing world  that moves me every time.

PROFESSOR GRAEME CLARK: I'd like to see us getting perfect sound, and also being able to hear in noise. One of our efforts to do that is to implant cochlear implants in each ear. 'Cause you and I know that two ears are better than one, and we can hear better in noise.

PROFESSOR GRAEME CLARK: To achieve our next goal of a new bionic ear, we've also got to learn how to process the signal, and we've got to mathematically model how the brain works to see how we can better design a bionic ear through the way the brain works. Because, after all, the brain does it better than computers. I'm now collaborating with St Vincent's Hospital and the University of Wollongong to develop these intelligent polymers and grow nerves on them, so that we can make better contact with the hearing nerve, and so create better bionic ears. And also this will allow us, I hope, to take people with broken spinal cords and bridge the gap and allow the nerves to connect from the top to the bottom so that they may be able to feel again, have body function and hopefully walk again.

GEORGE NEGUS: Well, that's astounding, if that's what you're up to. That is incredible. I mean, we jokingly talked about the Six Million Dollar Man and the Bionic Man, etc, but is that what you're talking about there?

PROFESSOR GRAEME CLARK: Well, yes. There's tremendous possibilities nowadays for combining, uh, medicine, biology, with the new advances in technology. And we're getting down to 1000ths of a millimetre with nanotechnology, we're developing intelligent plastics... But what we need are people like ourselves to use this to not only help produce better bionic ears, but also help people with other neural problems like spinal cord injuries, uh... But, uh, it's a flow-on effect. We are also working, uh, with the challenge of helping to diagnose people who have an epileptic fit before it happens so that we can perhaps induce electrical signals to help them, and also with heart pacemakers...

GEORGE NEGUS: The sky's the limit. You feel that there's nothing - no area of this fight that you can't have a go at, at least.

PROFESSOR GRAEME CLARK: Uh, well, there are limits. We do feel that we have expertise  not only with a bionic ear, but with a new field of bionics  which is really biology working closely with electronics and technology. My hope, my desire, is that we'll bring all this together here, in a centre in Australia, to actually have bio-medicine, bio-engineering, uh, so it's bigger than the bionic ear.

GEORGE NEGUS: That's the fire in the belly at the moment for Graeme Clark, is to create this institute, this research situation, where you can bring all these things together?

PROFESSOR GRAEME CLARK: That's the goal and the dream. Uh, people of course said the bionic ear wouldn't work, and although there are many, many challenges ahead with the relief of spinal cord injuries, I believe that if we tackle it like we did with the bionic ear  systematically, scientifically  and do as we did in Australia  bring them all together under the one roof so they can all communicate and talk together in the same tearoom  we will do the best we can to achieve what may be possible.

GEORGE NEGUS: You must have wondered whether it was all worth it when you were facing so much criticism. When you try making the deaf hear, and as the Bible says, "Now the lame walk," almost. I mean, what kept you going? 'Cause I know you're a religious person.

PROFESSOR GRAEME CLARK: It was, uh, tough. Um, and there were many times when I sort of felt I might... oh, nearly quit, but I didn't. Margaret, my wife, was, uh, the optimist. I'm the sort of part pessimist. But it was partly, uh, my wife, it was partly, uh, my determination, and it was my Christian faith too that really got me through.

GEORGE NEGUS: You actually see a serious connection between religion and science, don't you? You don't think the two are necessarily at odds.

PROFESSOR GRAEME CLARK: No, I don't. Some of the greatest scientists early on were Christian, and did so because of their faith. And today there are many. And I think that one can reconcile the two  they're different levels of explanation. It did become part of my walk, part of my journey. And also, I did as a good scientist should do  I said, "I'm putting forward the hypothesis, 'Is God real?' and I want to put God to the test." Which is not something one should do.

GEORGE NEGUS: Well, I can see you would. It's a... you use the word 'journey'  clearly yours is far from over.

PROFESSOR GRAEME CLARK: I would like to feel there's a few more horizons to reach yet.